Treatment of children with progressive or recurrent brain tumors with carboplatin or iproplatin: a Pediatric Oncology Group randomized phase II study.

Hs, Friedman; Jp, Krischer; Burger, Peter C.; Wj, Oakes; Hockenberger, Beverly; Weiner,; Jm, Falletta; Norris, Donald G.; Ah, Ragab; Dh, Mahoney

doi:10.1200/jco.1992.10.2.249

Cited by 170 publications

(66 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The relapse-free results to date are consistent with the previously reported 23,25,28,29,38 efficacy of thiotepa and carboplatin against brain tumors and poor-prognosis germ cell tumors; the addition of topotecan may enhance efficacy. A beneficial role for this or any other myeloablative regimen in the treatment of metastatic sarcomas is uncertain.…”

Section: Discussionsupporting

confidence: 79%

“…Reasons for treatment intensification in such patients using thiotepa, carboplatin, and topotecan included the steep dose-response antitumor effect of alkylators, 21,22 evidence that alkylators are non-crossresistant, 22 the enhancing effect of topotecan on alkylator cytotoxicity, 7 and the activity of each agent against a broad range of cancers, including brain tumors. [9][10][11][12][13][22][23][24][25][26][27][28][29][30][31] Toxicity was severe but manageable. Assessment of antitumor efficacy was limited by CR status at study entry of most patients, short follow-up, post-transplant use of biological therapies in neuroblastoma patients, and the small number of patients with other tumors.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Topotecan combined with myeloablative doses of thiotepa and carboplatin for neuroblastoma, brain tumors, and other poor-risk solid tumors in children and young adults

Kushner

Cheung

Krämer

et al. 2001

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Topotecan appears to be relatively unaffected by the most common multidrug resistance mechanisms, may potentiate cytotoxicity of alkylators, has good penetration into the central nervous system, is active against a variety of neoplasms, and has myelosuppression as its paramount toxicity. We present our experience with a myeloablative regimen that includes topotecan. Twenty-one patients with poor-prognosis tumors and intact function of key organs received topotecan 2 mg/m 2 by 30-min intravenous (i.v.) infusion on days −8, −7, −6, −5, −4; thiotepa 300 mg/m 2 by 3 h i.v. infusion on days −8, −7, −6; and carboplatin by 4 h i.v. infusion on days −5, −4, −3 with a daily dose derived from the pediatric Calvert formula, using a targeted area under the curve of seven mg/ml* min (ෂ500 mg/m 2 /day). Stem cell rescue was on day 0. The patients were 1 to 29 (median 4) years old; 18 were in complete remission (CR) and three in partial remission (PR). Early toxicities were severe mucositis and erythema with superficial peeling in all patients and a seizure, hypertension, and renal insufficiency followed by veno-occlusive disease in one patient each. Post-transplant treatment included radiotherapy alone (four patients) or plus biological agents (11 patients with neuroblastoma). With a follow-up of 6+ to 32+ (median 11+) months, event-free survivors include 10/11 neuroblastoma patients (first CR), 4/5 brain tumor patients (second PR or CR), 1/3 patients with metastatic Ewing's sarcoma (first or second CR), and a patient transplanted for multiply recurrent immature ovarian teratoma; a patient with desmoplastic small round-cell tumor (second PR) had progressive disease at 8 months. Favorable results for disease control, manageable toxicity, and the antitumor profiles of topotecan, thiotepa, and carboplatin, support use of this three-drug regimen in the treatment of neuroblastoma and brain tumors; applicability to other tumors is still uncertain. Bone Marrow Transplantation (2001) 28, 551-556.

show abstract

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Topotecan combined with myeloablative doses of thiotepa and carboplatin for neuroblastoma, brain tumors, and other poor-risk solid tumors in children and young adults

Kushner

Cheung

Krämer

et al. 2001

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…Carboplatin is an alkylating agent widely used in the treatment of human tumours, and the synergistic effect when used together with etoposide has been proved either in vitro and in vivo. Carboplatin has exhibited activity against malignant glioma in vitro (Dodion et al, 1988), and it has been widely used to treat both paediatric (Gaynon et al, 1990;Friedman et al, 1992;Gururangan et al, 2002) and adult (Poisson et al, 1991;Twelves et al, 1991;Yung et al, 1991;Warnick et al, 1994) brain tumour patients.…”

Section: Discussionmentioning

confidence: 99%

Phase II trial of carboplatin and etoposide for patients with recurrent high-grade glioma

et al. 2004

View full text Add to dashboard Cite

We present the results of a phase II trial of carboplatin and etoposide (CE) combination as first-line chemotherapy in patients with recurrent glioblastoma multiforme (GBM) and anaplastic astrocytoma (AA) after surgery and radiotherapy. We assess the activity and the tolerability of this combination. 30 patients with GBM (25) and AA (5) were treated with VP-16 (etoposide) 120 mg m À2 and CBCDA (carboplatin) 100 mg m À2 for 3 days every 4 weeks. Moreover, we performed a retrospective analysis of topoisomerase IIa gene status using chromogenic in situ hybridisation. The median age was 54 years (21 -73 years); Eastern Cooperative Oncology Group performance score was 0-1 in 25 patients and 2 in five patients. All patients had been previously treated with surgical resection (21 radical resections) followed by radiation therapy (40 -60 Gy). We observed six (20%) complete responses, three (10%) partial responses and 12 (40%) stable diseases, with a response rate of 30%. The median time to progression was 4 months, while progression-free survival at 6 months was 33.3%. The median survival time was 10 months. Neutropenia occurred in 9 patients: four patients had grade 4, two patients grade 3 and three patients grade 2. In the conclusion of this clinical trial, the CE combination has shown activity in recurrent GBM and AA, with a good toxicity profile. Alterations in the copy number of topoisomerase IIa gene seem to be a rare event and in our series do not influence response to the CE combination.

show abstract

“…A variety of drugs have been used, including vincristine, actinomycin D, etoposide, carmustine, and carboplatin, as well as combination regimens consisting of these drugs (R. Prados, personal communication, 1996). [5,14,17,18,20,21,24] In 1989, a study was begun to evaluate the efficacy of combining carboplatin and vincristine in treating children with recurrent and newly diagnosed astrocytomas. The objective response rates of 60 children, including 37 with newly diagnosed astrocytomas, have been reported.…”

mentioning

confidence: 99%

Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas

Packer¹,

Ater²,

Allen³

et al. 1997

FOC

View full text Add to dashboard Cite

The optimum treatment of nonresectable low-grade gliomas of childhood remains undecided. There has been increased interest in the use of chemotherapy for young children, but little information concerning the long-term efficacy of such treatment. Seventy-eight children with a mean age of 3 years (range 3 months-16 years) who had newly diagnosed, progressive low-grade gliomas were treated with combined carboplatin and vincristine chemotherapy. The patients were followed for a median of 30 months from diagnosis, with 31 patients followed for more than 3 years. Fifty-eight children had diencephalic tumors, 12 had brainstem gliomas, and three had diffuse leptomeningeal gliomas. Forty-four (56%) of 78 patients showed an objective response to treatment. Progression-free survival rates were 75 ± 6% at 2 years and 68 ± 7% at 3 years. There was no statistical difference in progression-free survival rates between children with neurofibromatosis Type 1 and those without the disease (2-year, progression-free survival 79 ± 11% vs. 75 ± 6%, respectively). The histological subtype of the tumor, its location, and its maximum response to chemotherapy did not have an impact on the duration of disease control. The only significant prognostic factor was age: children 5 years old or younger at the time of treatment had a 3-year progression-free survival rate of 74 ± 7% compared with a rate of 39 ± 21% in older children (p < 0.01). Treatment with carboplatin and vincristine is effective, especially in younger children, in controlling newly diagnosed progressive low-grade gliomas.Key Words * glioma * chiasmatic glioma * low-grade glioma * brainstem tumor * chemotherapy * children Gliomas comprise more than 50% of all childhood brain tumors and approximately 80% of these lesions

show abstract

Treatment of children with progressive or recurrent brain tumors with carboplatin or iproplatin: a Pediatric Oncology Group randomized phase II study.

Abstract: Carboplatin is active against low-grade gliomas. Further evaluation of the role of carboplatin in the preirradiation treatment of children with low-grade gliomas of the optic pathway is currently underway in a clinical trial.

Cited by 170 publications

References 9 publications

Topotecan combined with myeloablative doses of thiotepa and carboplatin for neuroblastoma, brain tumors, and other poor-risk solid tumors in children and young adults

Topotecan combined with myeloablative doses of thiotepa and carboplatin for neuroblastoma, brain tumors, and other poor-risk solid tumors in children and young adults

Phase II trial of carboplatin and etoposide for patients with recurrent high-grade glioma

Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas

Contact Info

Product

Resources

About